Excimer laser phototherapeutic keratectomy for corneal diseases.

The efficacy and safety of excimer laser phototherapeutic keratectomy (PTK) for treatment of various corneal pathologies were determined. The preoperative indications included lattice dystrophies (10 eyes), Reis-Bücklers dystrophies (4 eyes), macular dystrophies (2 eye), and corneal scarring secondary to trauma (1 eye). Mean follow-up time was 9.9 months (range 6-18 months). Uncorrected visual acuity postoperatively improved in 15 eyes (88.2%); not improved in 1 eye (5.9%) and decreased in 1 eye (5.9%). Corneal clarity improved in 14 of 17 eyes (82.4%) which corresponded to the improvement of uncorrected visual acuity. Ocular discomfort improved in 16 eyes (94.1%), decreased in 1 eye (5.9%) which subsequently developed double vision. The complications included delayed reepithelialization (> 7 days) in 6 eyes (35.3%) and corneal scarring 1 eye (5.9%). Sixty four per cent had increased significant hyperopia (> 4 D) and 7.1 per cent had significant induced astigmatism (> 2 D). One eye (5.9%) needed retreatment due to remaining corneal opacity. One eye (5.9%) had double vision due to irregular astigmatism. Excimer laser PTK is effective and safe for treatment of various corneal pathologies. It thus appears to be an alternative to penetrating keratoplasty in some patients.

Excimer laser photorefractive keratectomy and laser in situ keratomileusis for myopia and astigmatism.

The efficacy, predictability, safety, and short-term stability of excimer laser photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) for treatment of myopia and astigmatism were determined. The preoperative myopia ranged from -1.50 to -15.75 D and the astigmatism was less than 4.0 D. Of the 147 eyes, 73 and 74 underwent PRK and LASIK, respectively. Mean preoperative spherical equivalent refraction (SE) was -3.72 +/- 1.69 D in the PRK group and -7.66 +/- 2.30 D in the LASIK group. Mean postoperative SE at the last examination (3 to 6 months) was -0.13 +/- 0.82 D and -0.38 +/- 1.19 D in the PRK and LASIK groups, respectively. Eighty six percent in the PRK group and 77 per cent in the LASIK group achieved a SE within +/- 1.0 D and the refractions were stable between 1 month and 3-6 months. Uncorrected visual acuity of 20/40 or better was noted in 91 per cent in the PRK group and 97 per cent in the LASIK group. No eyes lost one or more lines of best spectacle-corrected visual acuity in both groups. PRK and LASIK appear to be effective, safe, predictable, and short-term stable in treating myopia and astigmatism. Longer follow-up studies will help evaluate the long-term stability of the procedure and possibility of later complications.